09 January 2017

Spirituality and Mental Health

Spirituality and Mental Health
Research on how faith in God impacts one's emotional well being.
[herewith are four articles/perspectives]

It had been barely four months since starting my clinical training at Harvard’s McLean Hospital and no less than 15 patients had approached me to speak about spirituality. I guess my kippah gave me away as a safe person to approach about the subject, but this was starting to get ridiculous. And so, I approached my advisor for advice.
“Rosmarin, these patients have spiritual needs that we’re not addressing.”“I agree. I’ve been saying this for years!”“But we need to do something about this problem. I want you to start a group to address patients’ spirituality in our program.”
McLean’s Spirituality – Cognitive Behavioral Therapy

And so, McLean’s Spirituality; Cognitive Behavioral Therapy group was born. Fortunately, I had received training in this subject – a rarity for a clinical psychologist, even in this age of spiritual awakening. My graduate school supervisor Kenneth I. Pargament, Ph.D. (Bowling Green State University) literally wrote the book on Spiritually Integrated Psychotherapy, and his 100+ scientific articles have consistently highlighted the importance of spiritual and religious life to psychological health. In just over one year, the group has provided spiritually-integrated treatment to over 150 patients. And feedback has been overwhelmingly positive – a full 25% of patients requested more such treatment and none provided negative comments.

Given Freud’s characterization of religion as neurosis, this is a big step forward. My colleagues were somewhat surprised.
 “Yes, I know that a lot of people believe in God, but does it really matter to mental health?” 
Given the history – from Freud’s characterization of religion as neurosis, to mechanistic biological models of mental illness – marginalization and discounting of spirituality (as opposed to disparaging it) is actually a big step forward. But even a cursory glance at the empirical literature reveals that spirituality does indeed matter to mental health – in a big way.

Over 47,000 scientific articles have been written on the subject of spirituality and health (PubMed search – June 2011), of which at least half relate to psychological symptoms and wellbeing. 

It is now recognized that this domain can protect against depression, anxiety, and facilitate greater self-control. Moreoer, it is now patently clear that religion can (and often does) serve as a vital resource for individuals coping with life change. For example, among individuals with advanced cancer, turning to religion can greatly enhance quality of life. Further, simple involvement such as weekly attendance of religious services has been associated with full 7-year increase in lifespan in some studies and some have argued on this basis that church is more cost effective than Lipotor. Source with footnotes: Spirituality-Mental Health

Prominent scientists show the efficacy of trust in God to treat anxiety.
(excerpts from original article, link included)

[…] In short: "The Gate of Trust in God." The pages were an excerpt from the book Duties of the Heart, written by Rabbi Bachaya Ibn Pekuda in 11th Century Spain. "I don't know if you should speak to a mental health professional about your anxiety," the rabbi said to David, "but I do know that reading these pages will help you. Learn them for 10-15 minutes each night before you go to bed, and contemplate deeply what is written here.” Excellent article (Source Aish: G–d vs. Prozac)

[upon rereading this text] "The Gate of Trust in God," this time analyzing the text from a psychological perspective. "Less than three pages into my reading," David remembers, "I realized that the text could be understood as a complete psychological theory of the etiology of human anxiety. This ancient piece of Jewish wisdom elucidated a secret method of eliminating human anxiety based on spiritual wisdom. I presented the material to my academic supervisors who were equally impressed by Rabbi Bachaya's insights."

A Torah Approach to Anxiety Relief
By Sara Esther Crispe

[…W]e need to know that a certain amount of anxiety in our lives is normal. It is part of life. We are shown this in the beginning passage of the Torah: “In the beginning . . . the earth was without form and void . . . and darkness was on the face of the deep . . . And G‑d said, ‘Let there be light,’ and there was light. G‑d saw that the light was good, so G‑d separated the light from the darkness . . . And it was evening, and it was morning, one day.” (Genesis 1:1–5)

From this seminal passage we see that:  Darkness preceded light.

In order for light to exist, it had to be created. It didn’t exist on its own. And even when light was created, it was still mixed together with darkness and had to be separated from it. A full phase of revelation—“one day”—is complete only when it includes both darkness (evening) and light (morning).

And in the fifth verse of the Torah we read, Vayikra Elokim la’or yom, “And G‑d called the light ‘day.’” What this teaches us is that “day,” which consists of both light and darkness, is the same word that is used for just light. This means that even though light and darkness may both exist, what is dominant and what defines the day is the light.

It is known that the darkest part of the night is just before the dawn. Often it is easy to think that life would be so nice, so easy, if it were simply smooth—a life filled with only light and no darkness. But just as on an EKG, the sign of life is a heartbeat that goes up and down . . . so too our lives have bumps in the road, and the ups and downs are all a part of living. The question is not if there will be bumps, but rather how will we deal with those bumps when we hit them.

There are numerous times in the Torah which speak of anxiety, but there is one important passage that teaches us some very practical ways of dealing with the anxiety in our lives. Clearly, this is not going to be a solution for someone suffering from depression or mental illness who is in need of professional help and perhaps medication. But rather, it is for the typical bumps we encounter in our lives.

The sign of life is a heartbeat that goes up and down, The statement is in Proverbs, which was written by King Solomon. It reads: “Anxiety in the heart of a person causes dejection, but a good word will turn it into joy.” The Hebrew for this is: Da’agah belev ish yashchenah, vedavar tov yesamchenah (Proverbs 12:25).

Here we see how complex the Hebrew language is, and how understanding its various levels of meanings lead to multiple teachings of the subject at hand. We find that the word for “dejection,” yashchenah, has three different meanings, depending on how the word is read. 

It can mean: 1. to suppress. 2. to ignore. 3. to articulate. 

To continue this reading this for clarification,  Jewish Approach to Anxiety Relief

Depression – It’s Nothing New Mental Illness in Jewish Tradition
by Azriel Hauptman
Rabbi Hauptman is Director of Relief of Baltimore, a recently established mental health referral service. Contact him at ahauptman@reliefhelp.org or at 410-448-8356

[…T]here is a notion that it is somehow un-Jewish to suffer from depression. Shouldn’t the Torah infuse our hearts with happiness – or at least provide the remedy for depression?

In order to address these misconceptions, we must realize that not only are mental health disorders as real as other medical conditions, and have been around since we left the Garden of Eden, but also that the Talmud itself discusses depression.

The Talmud (Shabbos 30b) tells us that it is permitted to extinguish a candle on Shabbos because of an “Evil Spirit,” since the Evil Spirit can possibly be fatal if the patient is exposed to the candlelight. This is perplexing. What is this Evil Spirit that the Mishnah is describing? What kind of spirit can be life threatening if the candle is not extinguished?

The Rambam (1138 – 1204), in his commentary to the Mishnah, writes, “The Evil Spirit is referring to melancholy. There is a type of melancholy that will cause the ill person to lose his mind when he sees light or when he is amongst other people. He finds peace only in darkness, in solitude, and in desolate places.”

“Melancholy” is the ancient term for depression and was until the 20th century the word of choice in the English language as well. (The word comes from the Greek for black bile, as the ancient Greeks believed that the cause of depression is an excess of black bile. In classic Rabbinic literature, the term mara shehora is used for depression, which also means black bile.) The word depression was coined by the mental health profession, causing the word melancholy to be used much less frequently in a clinical sense.

So now we recognize that (according to the Rambam) the Talmud is teaching us that a person can be in such a deep depression that he needs to be in the dark in order to retain his sanity, otherwise he might lose his mind in a way that can be life threatening. But is light sensitivity indeed one of the symptoms of depression?

Well, light sensitivity (also known as photophobia) is not one of the common symptoms of depression, but it definitely is a symptom that some people experience. Dr. Kathleen Digre, professor of ophthalmology and neurology at the University of Utah, said that some people can tell how depressed they are by how light sensitive they are. The other symptom that the Rambam mentions is the desire to be alone. Social withdrawal is a common symptom of depression. There are many symptoms of depression, and a diagnosis of depression is based on the presenting symptoms of the individual. Obviously, this diagnosis must be made by a competent mental health professional.

Incredibly enough, the Rambam also offers advice for people who suffer from depression. In Shemona Perakim (“Eight Chapters” – the Rambam’s introduction to Avos) in Chapter 5, the Rambam writes, “If a person develops melancholy, he should eliminate it by listening to music and songs, by strolling in gardens and amongst beautiful buildings, and by sitting amongst beautiful images, and other ways of broadening the mind, and then he will remove the distress of his melancholy.”

Clearly, the Rambam’s advice is based on the information available in medieval times. Today, mental health professionals have many different tools in their toolbox to treat depression, ranging from psychotherapy to psychotropic medications.

However, one lesson we can learn from the Talmud and the Rambam is that “there is nothing new under the sun,” and that people have been dealing with depression for thousands of years. There is nothing shameful about it, and nothing un-Jewish about seeking treatment for depression and other mental health disorders. Additionally, just as the Rambam enlightens the Torah for us in so many ways, he also shines a bright light into the mental health field, advising us to use whatever means are available to us to treat mental health conditions. Source: Depression . . . Nothing New

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